Walker R H
Division of Orthopedic Surgery, Scripps Clinic and Research Foundation, LaJolla, Calif.
Orthopedics. 1994 Jul;17 Suppl:14-7. doi: 10.3928/0147-7447-19940702-07.
Prophylaxis of venous thromboembolism can be categorized as primary prevention and secondary prevention. Primary prevention is the deterrence of a disease process before it begins. Secondary prevention is the detection and treatment of an asymptomatic disease process before it becomes symptomatic. This discussion deals with duplex ultrasonography as a method of secondary prevention of venous thromboembolism after total joint replacement. Routine screening by venography and by duplex ultrasonography has been advocated by several authors in cases of total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, compared with venography, duplex ultrasonography has the advantages of being portable, painless, noninvasive, without side effects, less expensive and, depending on the institution, reliable as a screening and surveillance tool for managing deep vein thrombosis (DVT). Part one of a three-part study was designed to substantiate reliability of duplex ultrasonography in detecting DVT after total joint replacement in the lower extremity at our institution (Scripps Clinic and Research Foundation in La Jolla, Calif). Parts two and three were designed to evaluate the utility of duplex ultrasonography for routine screening and surveillance of DVT after THA and TKA.
静脉血栓栓塞的预防可分为一级预防和二级预防。一级预防是在疾病过程开始之前进行预防。二级预防是在无症状疾病过程出现症状之前进行检测和治疗。本文讨论双功超声作为全关节置换术后静脉血栓栓塞二级预防的一种方法。几位作者主张在全髋关节置换术（THA）和全膝关节置换术（TKA）病例中通过静脉造影和双功超声进行常规筛查。然而，与静脉造影相比，双功超声具有便携、无痛、无创、无副作用、成本较低的优点，并且根据机构不同，作为管理深静脉血栓形成（DVT）的筛查和监测工具也较为可靠。一项分为三部分的研究的第一部分旨在证实双功超声在我们机构（加利福尼亚州拉霍亚的斯克里普斯诊所和研究基金会）检测下肢全关节置换术后DVT的可靠性。第二部分和第三部分旨在评估双功超声在THA和TKA术后DVT常规筛查和监测中的效用。
